Food and Fluids

See also: VSED (Voluntarily Stopping Eating and Drinking)

Questions and Answers about “Artificial Feeding” The ethical implications of withholding or withdrawing food and fluids.

Symptoms of Dehydration If all food and fluids are removed from a person, death by dehydration will occur.

Cases: Wendland (CA)   Schiavo (FL)  Martin (MI)

“Should Nursing Homes Be Forced to Starve Dementia Patients?”
(National Review — March 30, 2018)
Assisted-suicide advocates are pushing an “aggressive advance directive” that would force nursing homes to starve dementia patients — even if they willingly eat — when they reach a specified stage of cognitive decline.

“‘Aggressive’ Advance Directive Permits Halting Food and Water in Severe Dementia”
(NPR — March 29, 2018)
The New York document says, “My instructions are that I do NOT want to be fed by hand, even if I appear to cooperate in being fed by opening my mouth.”
…Directors of End of Life Choices in New York consider the document “legally sturdy,” [Judith] Schwarz writes, adding: “Of course it’s going to end up in court.”

“Dementia Patient at Center of Spoon-feeding Controversy Dies”
(California Healthline — October 12, 2017)
Nora Harris who was diagnosed with early-onset Alzheimer;s had drafted an advance directive that called for no measures to prolong her life, including artificial nutrition and hydration.  Her husband contended that the document covered oral assisted feeding too and went to court last year to force staff at the facility where she was cared for to stop spoon-feeding her.
A judge denied his request, siding with Oregon’s long-term care ombudsman who said state rules to prevent abuse required the center to offer residents three meals each day and provide help eating, if needed.
More on Alzheimer’s

“Judge rules anorexic Morris woman can’t be force-fed”
(Daily Record — New Jersey — November 22, 2016)
The state Department of Human Services wanted A.G. — who has weighed between 60 and 69 pounds in the past year — to be force-fed and additionally helped through an experimental program for her depression and increased time with family and pets.
Judge Paul Armstrong said that during the interview with A.G. on Nov. 3, “Her testimony may be fairly summarized as an impassioned, deeply-held rejection” of force-feeding and further treatment for the disorder.

“Ashland woman didn’t want life prolonged, but state says she must be spoon-fed”
(Mail Tribune — September 18, 2016)
Nora Harris is being spoon-fed because the State Long-Term Care Ombudsman Office says the nursing facility where she lives must help her eat….Fred Steele, agency director of the state office, says there is a legal question about whether advance directives can be used to express a wish not to be assisted with regular feeding.

“Push Continues to Starve Dementia Patients”
(National Review — September 18, 2016)
Although food isn’t being shoved in Nora’s mouth, Crain said in some ways Nora is being forced to eat because if she were still competent she would not want the spoon-feeding intervention.

“High-profile right-to-die case in B.C. faces new probe”
(Vancouver Sun — March 1, 2016)
The action comes after Margot Bentley’s family stopped paying $4,000 a month to the nursing home where she lives to protest the home’s refusal to stop spoon-feeding her.

“How Margot Bentley is complicating the right-to-die debate”
(CBC — June 14, 2015)
She is unresponsive in every way but one.  She continues to eat when prodded with a spoon…Earlier this year the court ruled that by opening her mouth Bentley was consenting to be fed.  The judge said feeding with a spoon is not medical care.  It is personal care and thus not included in Bentley’s directive….Margot Bentley’s family says they want the care home to stop spoon-feeding their mother.

“Boo Hoo, Poor Michael Schiavo”
(National Review — February 2, 2015)
Ever since Jeb Bush made noises about running for president, Michael Schiavo — who won a court ruling having his wife dehydrated to death — has been bashing Bush for trying to save Terri’s life.  Now, in Politico, a totally and one-sided report has Schiavo feeling sorry for himself….The effort to save Terri Schiavo’s life was entirely bipartisan, including cooperation from Hillary Clinton, Barack Obama, Joe Biden, Harry Reid, and Tom Harkin.

“Family appeals court ruling that refused to let Margot Bentley die”
(Vancouver Sun — April 22, 2014)
The family of Margot Bentley, a former nurse with Alzheimer’s, is appealing the B.C. Supreme Court ruling that allowed her Abbotsford nursing home to continue spoon-feeding her.

“Thousands die of thirst and poor care in NHS”
(Telegraph — UK — April 22, 2014)
[T]he NHS watchdog NICE was forced to issue guidelines on giving patients water after it found that 42,000 deaths a year could be avoided if staff ensured the sick were hydrated.

“Family’s Euthanasia Fight for Natty”
(CBS Local — March 25, 2014)
“We euthanize serial killers, because that’s more humane. But, a 21-month old baby has to starve for almost 9 days in front of her family.”
[Grandfather calls for legalization of euthanasia for children following starvation death of toddler.}

“More than a thousand care home residents die thirsty”
(Telegraph — December 1, 2013)|
Elderly and vulnerable patients were left without enough water despite being under the supervision of trained staff in homes in England and Wales.
More on United Kingdom

“No ‘Spoon Feeding!’ Case to BC Supremes”
(National Review Online — November 21, 2013)
At stake is whether a nursing home can be forced to starve a patient to death by withholding spoon feeding. The patient is voluntarily swallowing. No one is forcing food or water down her throat.

“Nursing Home Won’t Starve Mother — Family Sues”
(National Review — August 8, 2013)
In Canada, a family wants a nursing home to stop spoon feeding their mother because she would not want to be kept alive with Alzheimer’s.

“Patient’s family sues B.C. as nursing home keeps her alive against her wishes”
(Vancouver Sun — August 7, 2013)
The actions of Abbotsford nursing home staff who are spoon-feeding an 82-year-old Alzheimer’s patient — contrary to the wishes she expressed in her living will –constitute battery, a lawsuit by her daughter and husband alleges.
Margot Bentley’s daughter, Katherine Hammond, said she doesn’t visit her mom much anymore.

“Family of B.C. woman ravaged by Alzheimer’s fights to fulfill her right to die with dignity”
(National Post — July 10, 2013)
In 1991, Margot Bentley drafted a detailed “living will.” She wrote that health care workers were to dispense “no nourishment or liquids” if it was clear she had no chance of recovery.”
According to her daughter, Bentley’s regular spoon-feeding should stop.

“Man at center of family’s end-of-life care dispute dies”
(Fox 59 – Indiana — March 20, 2013)
He was taken off a ventilator and his end-of-life directives were followed.  Smith, however, did not die. He began asking for food and water…

International promotion of VSED (voluntarily stopping of eating and drinking) moves into high gear:
“How I helped my mum to die”

(Mail Online — August 4, 2011)
They were never — but then Jane agreed to help her ailing mother starve herself to death….”There was no pretending I hadn’t been part of her decision and had arguably even encouraged it. Many experts say that old people often choose to end their lives, or say they don’t want them extended, not because of their own genuine wishes, but to spare their children trouble and expense.”

“Right-to-die patient displays ‘a bit of a smile’ when teased, carer claims”
(Mail Online — July 20, 2011)
Her partner and sister have made an emotional plea to the judge, Mr. Justice Baker, to remove her hydration and feeding tube. But today, her carer told the High Court the woman could display “a bit of a smile” and make different noise when carers joked about men…It is thought to be the first time that a judge has been asked to rule on whether life-supporting treatment should be withdrawn from a person who is “minimally conscious”, one level above a “persistent vegetative state”….Vikram Sachdeva, for the relatives, says M’s family felt that she would not want to live a life “dependent on others.”

“Family fight to end life of brain disease patient: Landmark case affecting thousands with locked in syndrome”
(Mail Online — July 18, 2011)
The 53-year-old — known only as M — has a brain-stem wasting disease and is “minimally conscious.” which means she is able to make some movements or experience some sensations. Relatives, including her mother, say she is often in pain and would be better off dead. They have applied to one of Britain’s most powerful courts for a judge to order the removal of her hydration and nutrition tubes, which will mean she dies of thirst and starvation….If the relatives’ application is successful, it could have implications for the 6,000 Britons who are so incapacitated that they can barely communicate.


“The Case of Theresa Schiavo” by Joan Didion
Exceptional, detailed, and lengthy discussion of Terri Schiavo’s life and death.
(The New York Review of Books, Volume 52, Number 10)

“Schiavo marker stirs family hostility”
Michael Schiavo chose to list Feb. 25, 1990 (the date of her collapse) as the date Terri “departed this earth” and inscribed “I kept my promise” on her bronze grave marker.  (USA Today, 6/20/05)

Terri Schiavo died of dehydration on March 31, 2005, thirteen days after her feeding tube was removed.  Her parents, brother and sister were denied access to her bedside at the time of her death.

Facts you may not know about Terri Schiavo’s case.

International Task Force amicus curiae brief in Terri Schiavo case.

Discusses biases of “expert” who testifed on behalf of Michael Schiavo.

Transcript of 9/27/04 Larry King Show with Terri’s parents, Bob and Mary Schindler.

“With intent to kill:   The battle over Terri Schiavo’s life continues” (International Task Force Update, Special Edition, 12/29/03)

“The fight to save Terri Schiavo’s life”
Background and status of case through 1/31/03 (ITF Update, Vol. 17, No. 1, 2003).

Official site of Terri Schindler-Schiavo Foundation


In a 6-0 opinion, the California Supreme Court has ruled in favor of protecting vulnerable conscious conservatees. The Court ruled that food and water cannot be withdrawn from a conscious disabled conservatee unless there is clear and convincing evidence that withdrawing food and water is what the patient wanted or that doing so would be in the patient’s best interest. The Court found that Rose Wendland (who sought to remove food and fluids from her conscious but severely brain-damaged husband ) had “offered no basis for such a finding other than her own subjective judgment that the conservatee did not enjoy a satisfactory quality of life and legally insufficient evidence to the effect that he would have wished to die.” (August 9, 2001)

Attorneys for Rose Wendland petitioned the Court to reconsider its decision. The Court denied the request on September 28, 2001.

Robert Wendland Dies (July 17, 2001)

“A Life in Limbo” The court battle over Robert Wendland (CNN Burden of Proof transcript 1/15/01)

Seeking the Death of Robert Wendland Appeared originally in Sacramento Bee (11/14/97).

Editor’s Update: Robert Wendland Spared Judge rules that there is not clear and convincing evidence that starving and dehydrating Wendland would be in his best interest. (IAETF Update, Nov.-Dec. 1997)


Mary Martin Continues to Speak Out Mary Martin, who failed in her attempt to have her husband’s food and fluids removed, claims that people like her husband could be the organ donors who are so desperately needed.(6/98)

Background Information on the Michael Martin Case Update articles from 1993-1995 which report on the case of Michael Martin and its outcome at the Michigan Supreme Court.

For an in depth discussion of the transformation of food and fluids into “medical treatment,” see the following sections from the article “Words, Words, Words”:

“The Morphing of ‘Treatment'” The debate about treatment has traveled so far beyond the original meaning of the word that it begs for redefinition in Webster’s.

“Food and Fluids as Medical Treatment” Considerable verbal engineering was required to transform denial of food and fluids into an appealing “removal of treatment.”

“Tube Feeding: Neither New Nor Rare” Tube feeding is neither new, exotic nor rare.

“Lunch Trays Bearing Treatment” Those who advocate removing food and fluids from disabled people, contend that even food taken by mouth is treatment if the person’s diet had to be approved by a physician.

“‘Graceful Death’ by Dehydration” A major medical journal portrayed dehydrating to death as a way for an elderly woman – who had no life threatening condition – to end her life “gracefully.”